NCG160172_DMR_20201109

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General Per it No. NCG160000 - Asphalt
Date submitted
CERTIFICATE OF COVERAGE NO. NCG16C� I a
SAMPLE COLLECTION YEAR �� ��
- SAMPLE PERIOD ❑Jan -June � July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow [:]Watersupply []SA
`{Other (V.RSS L
FACILITY NAME �LS� � OA_-0�2L
COUNTY C/kEA?-PUS
PERSON COLLECTING SAMPLESC10A?LQS (-fly/
LABORATORY UA�1'oit--�Lab Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
n No discharge this period?2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Total Suspended Solids
Benchmarks =__>
-
-
100 mg/L or 50 mg/L4
NOV 2 3 2020
ccN-r.
DWR S" CTIp ;
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a check mark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
4requirement. See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark
applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format "<XX ml:/L", where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3l responses. See General Permit text.
Permit Date: 08/01/2019-05/31/2024 SWU-252, last revised 09/04/2019
Page 1 of 2

Semi-annual Stormwater Discharge Monitoring Report (DMR)
for North Carolina DEMLR General P r 't No. NCG160000 - Asphalt
Date submitted
CERTIFICATE OF COVERAGE NO. CG 16C 17d
FACILITY NAME -
COUNTY C'AI�:>A�1-US
PERSON COLLECTING SAMPLESCIA`�'S Ch/rTy
LABORATORY+`l�iDi� LabCert.#
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
[]zero -flow ❑water Supply []SA
Other CLAD C
PLEASE REMEMBER TO SIGN ON THE REVERSE a
[c No discharge this period;2
outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Total suspended Solids
Benchmarks =__>
-
-
100 mg/L or 50 mg/L4
i36.,
ND PLO w
RECFivr- r-
NOV 2 3 2020
CCNIi,:p, FILE.
DWR SECTIO°
Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a check mark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge
4requirement. See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark
applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format "<XX mg/L', where XX is the numerical value of the
detection limit, reporting limit, quantitation limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 08/01/2019-05/31/2024 SWU-252, last revised 09/04/2019
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ONA
1Zl No discharge this period?'
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Non -polar O&G by EPA
1664 (SGT-HEM)
Total Suspended Solids
New Motor Oil or Hydraulic
Oil Usage, Annual average
gal/mo
Benchmarks =__>
-
-
15'mg/L
100 /L or SO mg/L°
-
Footnotes from Part A also apply to this Part B
Note. If you report a sample value in excess of the benchmark, you must implement Tier I, rer 2, or Ver 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BYTHE PERMIT? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitorina Period
in the case of "No Discharge" reports) to:
Division of Water Resources
Attn: DWR Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)
1:)
(Date)
Permit Date: 08/01/2019-05/31/2024 SWU-252, last revised 09/04/2019
Page 2 of 2